IBS & Diverticulitis

April 12, 2013

Today we are looking at two disorders of the gut, irritable bowel syndrome (IBS) and diverticular disease. Both are sadly more common than ever.

Irritable Bowel Syndrome: Symptoms of IBS range from pain in the gut, bloating, constipation and diarrhoea. This may be related to food, gut function and movement, stress and depression. The cause of IBS is not known but there is inflammation and/or infection in the gut, changes in serotonin levels and a family history in some patients with IBS.

While there is no cure for IBS, symptoms can be managed and the first thing to do is to look at diet and exercise. Keep a food and symptom diary to identify any foods that are causing flare-ups and avoid those foods. Food intolerances are different to allergies and often symptoms will be related to the amount of the foods that you eat. If you find you are intolerant to a particular food, you can limit or replace that food with something else in your diet.

Your food and symptom diary can also help you identify whether fermentable foods are contributing to your symptoms. Dr Shepherd has developed the low-FODMAP diet which improved symptoms of 70% of patients who stayed on it. Foods identified as being a problem in some people include apples, pears, asparagus, dairy, beans and chickpeas. Click here for more information. While the results are encouraging, there is no point avoiding foods unnecessarily so if no improvement in symptoms is noticed, simply re-introduce that food. Excluding gluten may help even when gluten sensitivity is not identified.

The way we eat can also improve symptoms. Don’t skip breakfast. The gut is ready to digest food well after the overnight fast. Chew your food thoroughly and slowly. Sit up straight when you eat. Lifestyle changes may also help. Moderate exercise has been shown to help symptoms, reduce stress and improve mood. Include leisurely walks, yoga or other relaxation techniques into your week. If depression is a factor, this should be treated by your doctor.

Some patients with IBS will find medications useful. Anti-diarrhoeal drugs, laxatives and antispasmodics can relieve symptoms. Since the gut flora appears to be abnormal in people with IBS, a probiotic can be used to restore and encourage healthy gut flora and regulate bowel movements. Lactobacillus plantarum in Ethical Nutrients IBS Support is specific for IBS control. Anti-inflammatories such as omega-3, curcumin (in Turmeric) and slippery elm bark may also be helpful to reduce inflammation.

Holistic Nutritionist Alison Cowell will be in-store on Wednesday 5th June offering health and nutrition assessments and/or food intolerance tests at a special rate for anyone mentioning this column. To book your appointment, phone her on 844 0587 and visit her website for more information.

Diverticular Disease: The word “diverticulum” means “cave” in Latin and diverticular disease is where the lining of the colon bulges to cause small pockets (or caves). This is very common in New Zealand, especially as we get older, affecting nearly half of Kiwis over 60 years. 15-20% of people with diverticular disease develop diverticulitis where the pockets become inflamed and cause pain, bleeding, fever, nausea and constipation. If there is strong pain and a high fever, the person should go to hospital immediately as a pocket may have burst.

The pockets in the bowel lining are thought to be caused by intermittent increases of pressure in the bowel over a long period of time. This can run in families which suggest genetic factors are involved and a diet which is low in fibre can aggravate the condition. Fibre can be found in fresh fruits, vegetables and whole grains and is important to keep stools soft and bulky so they pass easily through the colon. If the stool becomes hard, the muscles in the colon strain to move it causing pressure which can lead to parts of the colon wall to pop out into pockets. If there is no inflammation, increasing the fibre in the diet (20-35g/day) may be all that is required to improve diverticular disease and prevent episodes of diverticulitis. It is advisable to increase fibre gradually in the diet to avoid wind and abdominal pain. Drink at least eight glasses of fluids through the day too.

If diverticulitis occurs, your doctor will advise you about your diet while the area heals and may prescribe an antibiotic to prevent or treat infection. Many of the symptoms described for both these disorders are the same as other bowel conditions. If you have been experiencing them for some time or if you have noticed weight loss, anaemia or bleeding, you should speak to your doctor.